Marlow N, Greenough A, Peacock J L, Marston L, Limb E S, Johnson A H, Calvert S A
Queen's Medical Centre, Nottingham NG7 2UH, UK.
Arch Dis Child Fetal Neonatal Ed. 2006 Sep;91(5):F320-6. doi: 10.1136/adc.2005.079632. Epub 2006 May 11.
The long term outcome of children entered into neonatal trials of high frequency oscillatory ventilation (HFOV) or conventional ventilation (CV) has been rarely studied.
To evaluate respiratory and neurodevelopmental outcomes for children entered into the United Kingdom Oscillation Study, which was designed to evaluate these outcomes.
Surviving infants were followed until 2 years of age corrected for prematurity. Study forms were completed by local paediatricians at routine assessments, and parents were asked to complete a validated neurodevelopmental questionnaire.
Paediatricians' forms were returned for 73% of the 585 surviving infants. Respiratory symptoms were common in all infants, and 41% had received inhaled medication. Mode of ventilation had no effect on frequency of any symptoms. At 24 months of age, severe neurodevelopmental disability was present in 9% and other disabilities in 38% of children, but the prevalence of disability was similar in children who received HFOV or CV (relative risk 0.93; 95% confidence interval 0.74 to 1.16). The prevalence of disability did not vary by gestational age, but boys were more likely to have overall disability. Developmental scores were unaffected by mode of ventilation (relative risk 1.13; 95% confidence interval 0.78 to 1.63) and were lower in infants born before 26 weeks gestation compared with babies born at 26-28 weeks.
Initial mode of ventilation in very preterm infants has no impact on respiratory or neurodevelopmental morbidity at 2 years. HFOV and CV appear equally effective for the early treatment of respiratory distress syndrome.
进入高频振荡通气(HFOV)或传统通气(CV)新生儿试验的儿童的长期结局鲜有研究。
评估参与英国振荡研究的儿童的呼吸和神经发育结局,该研究旨在评估这些结局。
对存活婴儿进行随访至矫正胎龄2岁。研究表格由当地儿科医生在常规评估时填写,同时要求家长完成一份经过验证的神经发育问卷。
585名存活婴儿中有73%的儿科医生表格被返回。所有婴儿中呼吸症状常见,41%的婴儿接受过吸入药物治疗。通气模式对任何症状的发生频率均无影响。在24个月时,9%的儿童存在严重神经发育残疾,38%的儿童存在其他残疾,但接受HFOV或CV治疗的儿童中残疾患病率相似(相对风险0.9;95%置信区间0.74至1.16)。残疾患病率不因胎龄而异,但男孩总体上更易出现残疾。发育评分不受通气模式影响(相对风险1.13;95%置信区间0.78至1.63),与孕26 - 28周出生的婴儿相比,孕26周前出生的婴儿发育评分更低。
极早产儿的初始通气模式对2岁时的呼吸或神经发育发病率无影响。HFOV和CV在呼吸窘迫综合征的早期治疗中似乎同样有效。